NPI | 1376882563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: AL MD.34716) |
Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AL MD.34716) |
Enumeration Date | 2013-02-07 |
Last Update Date | 2025-06-16 |